Provider Demographics
NPI:1215148226
Name:M WASSEF DABBAS MD
Entity type:Organization
Organization Name:M WASSEF DABBAS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:M WASSEF
Authorized Official - Middle Name:
Authorized Official - Last Name:DABBAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-298-6654
Mailing Address - Street 1:1425 E STROOP RD
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-4927
Mailing Address - Country:US
Mailing Address - Phone:937-298-6654
Mailing Address - Fax:
Practice Address - Street 1:1425 E STROOP RD
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-4927
Practice Address - Country:US
Practice Address - Phone:937-298-6654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH041705207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty